Burden of respiratory syncytial virus infection in older adults hospitalised in England during 2023/24.

Objectives: We aimed to describe the incidence, presentation and clinical outcomes of RSV-associated acute respiratory infection (ARI) in older adults using a new national Hospital-based ARI Sentinel Surveillance (HARISS) system in England, prior to RSV vaccine introduction. Methods: Adults aged ≥65 years from seven hospitals admitted for ≥24 hours with symptomatic ARI were included. We estimated the hospitalisation rate of RSV-associated ARI compared to influenza-associated ARI and assessed clinical outcomes using Poisson regression and mortality using Cox regression. Results: This study included 2743 adults. During winter 2023/4 the hospitalisation rate for RSV-associated ARI was 58.3 per 100,000, compared to 114.6 per 100,000 for influenza-associated ARI. Hospitalisations increased with age. Exacerbation of chronic illness (lung disease, heart disease, frailty) was a common admission reason in RSV-associated ARI, with a combined incidence of 33.1 per 100,000. Most adults with RSV-associated ARI had at least one comorbidity (81%); a high proportion with immunosuppression (26%). Symptoms and clinical outcomes including mortality were similar between RSV- and influenza-associated ARI; 30-day mortality 10.6% vs 8.7% (adjusted hazard ratio 0.85, 95% confidence interval 0.6-1.2). Conclusions: In England, RSV infection is a common cause of hospitalisation in older adults. Symptoms and clinical outcomes, including mortality, are comparable to influenza.

Citation

Symes R, Keddie SH, Walker J, McKeever T, Ahmad S, Arnold D, Evans CM, Pelosi E, Rahman NM, Sapey E, Zambon M, Watson C, Bernal JL, Lim WS; HARISS network collaborators. Burden of respiratory syncytial virus infection in older adults hospitalised in England during 2023/24. J Infect. 2025 Sep;91(3):106570. doi: 10.1016/j.jinf.2025.106570. Epub 2025 Aug 6.

Type

Article